Plant stanol esters in low-fat milk products lower serum total and LDL cholesterol

Oil-based matrices enriched with plant stanol esters lower serum LDL cholesterol. The effects of low-fat milk products have been less thoroughly examined.

To evaluate the effect of three less explored low-fat milk products enriched with plant stanol esters on serum lipid concentrations in subjects with mild or moderate hypercholesterolemia.

A meta-analysis of four unpublished sub-studies (yoghurt, yoghurt single-shot drink: Studies I and II, or milk). All the substudies were randomized, placebo-controlled, double-blind and had a parallel-group design. They were carried out in order to evaluate the effect of low-fat milk products enriched with plant stanol esters on serum lipid concentration. Each stanol-ester-enriched milk product provided 2 g of stanols per day, and in each study the intervention period was 5 weeks. A total of 199 hypercholesterolemic subjects completed the studies.

The pooled treatment difference in total cholesterol was -3.8% (95% CI -6.0 to -1.7, p < 0.001) when stanol was compared to placebo. In LDL cholesterol, the pooled treatment difference was -4.9% (95% CI -7.8 to -1.8, p = 0.002). There were no significant differences between the groups in pooled HDL cholesterol or triacylglycerol concentrations. The results tended to be more pronounced when we were certain that the yoghurt single-shot drink was ingested with lunch, and when the baseline LDL-cholesterol concentration was > or = 3.5 mmol/l.

These results imply that low-fat milk products enriched with plant stanol esters lower both total cholesterol and LDL cholesterol statistically significantly in subjects with mild or moderate hypercholesterolemia. The changes tended to relate to the baseline LDL-cholesterol concentration.